Pyrazinamide related prolonged drug-induced liver injury: A case report.
Medicine (Baltimore)
; 101(39): e30955, 2022 Sep 30.
Article
em En
| MEDLINE
| ID: mdl-36181061
ABSTRACT
RATIONALE Drug induced liver injury (DILI) is a common side effect causing treatment discontinuation during tuberculosis (TB) treatment, and pyrazinamide (PZA) usually leads to a delayed and prolonged abnormal liver function of the 4 standard anti-tuberculosis regimens. However, a prolonged hepatitis lasting more than 4 months is rarely reported. PATIENT CONCERNS A 78-year-old man presented with general weakness and poor appetite on his seventh week of anti-TB treatment for tuberculosis lymphadenitis. DIAGNOSIS Drug induced liver injury, PZA-related. NAT2 slow acetylator phenotype was accidentally found during workup of DILI. INTERVENTION A liver biopsy was performed and PZA-related DILI was suspected. All anti-TB medications were therefore discontinued. OUTCOME:
After withholding all anti-TB medications for 4 months, the elevations of aminotransferases and hyperbilirubinemia completely resolved. Anti-TB therapy was switched to ethambutol and levofloxacin for 15 months without adverse events. Long-term ultrasound follow-up was performed and cervical lymphadenopathy completely resolved.CONCLUSION:
Our patient presents with PZA related prolonged DILI resolved after drug discontinuation for 4 months. NAT2 slow acetylator phenotype may be related to this condition through unknown mechanisms.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Arilamina N-Acetiltransferase
/
Tuberculose dos Linfonodos
/
Doença Hepática Induzida por Substâncias e Drogas
Idioma:
En
Ano de publicação:
2022
Tipo de documento:
Article